It is often said that just as the “instantaneous nature of an observed causal progression is a familiar element in cases dispensing with medical testimony, so a delay between the accident and the symptoms, disability or death diminishes any such self-evident causal relation [Larson’s Workers’...

Testimony by a claimant that she continued to have pain and discomfort almost 23 years after sustaining a work-related back injury, together with a physician’s notes that indicated those same complaints had been recounted to the doctor at an office visit, but which were silent with regard to causation...